Validation of PaO2 / PALVO2 ÷ RSBI × FiO2 index during weaning from mechanical ventilator in chronic obstructive pulmonary patients: An observational prospective multi center trible blinded clinical trial

Weaning from mechanical ventilator is one of the most challenging issues of hospitalized chronic obstructive pulmonary patients in intensive care unit. Introducing new index to anticipate the patient's weaning from mechanical ventilator with more successful probability is so paramount. The study had two-fold purposes including 1. Determining cut-off points of vahedian one and common indices RSBI, P0.1, NIF, CROP, and IWI in the population of chronic obstructive pulmonary patients; and 2. Comparing different weaning factors from mechanical ventilator of vahedian one and RSBI, P0.1, NIF, CROP, and IWI indices in the population of chronic obstructive pulmonary patients.
Present study was an observational, prospective multi center trible blinded clinical trial that conducted from January 2013 to March 2014 in the population of hospitalized chronic obstructive pulmonary patients in critical care unit's of selected hospitals in Tehran in two groups including cut off points determining group (n = 90) and determining different predicting weaning factors from mechanical ventilator group (n= 90). The process of weaning from mechanical ventilator conducted same in both groups and was based on the defined protocol. ROC analysis used to determine cut off points in the first group and predicting factors in the second group.
Six indices Vahedian one, RSBI, IWI, P0.1, NIF, and CROP were comparing from different predicting weaning factor's view. Generally, RSBI, vahedian one, IWI, P0.1, NIF, and CROP indices were devoted the most favorably factors to itself, respectively. The highest area under the curves were devoted to RSBI (0.927) and vahedian one (0.888) indices.
Although the proposed index than other common indices has more components in weaning process from mechanical ventilator, but RSBI index in addition to simply, devoted to itself the most desirable characteristics of predictive weaning from mechanical ventilator. Furthermore, it is suggested that RSBI index use along with subjective, objective, and respiratory distress symptoms monitoring in the population of chronic obstructive pulmonary patients.